ABSTRACT
BACKGROUND: Denmark and Israel both have highly rated and well-performing healthcare systems with marked differences in funding and organization of primary healthcare. Although better population health outcomes are seen in Israel, Denmark has a substantially higher healthcare expenditure. This has caused Danish policy makers to take an interest in Israeli community care organization. Consequently, we aim to provide a more detailed insight into differences between the two countries' healthcare organization and cost, as well as health outcomes. METHODS: A comparative analysis combining data from OECD, WHO, and official sources. World Health Organization (WHO) and the Organisation for Economic Co-operation and Development (OECD) statistics were used, and national official sources were procured from the two healthcare systems. Literature searches were performed in areas relevant to expenditure and outcome. Data were compared on health care expenditure and selected outcome measures. Expenditure was presented as purchasing power parity and as percentage of gross domestic product, both with and without adjustment for population age, and both including and excluding long-term care expenditure. RESULTS: Denmark's healthcare expenditure is higher than Israel's. However, corrected for age and long-term care the difference diminishes. Life expectancy is lower in Denmark than in Israel, and Israel has a significantly better outcome regarding cancer as well as a lower number of Years of Potential Life Lost. Israelis have a healthier lifestyle, in particular a much lower alcohol consumption. CONCLUSION: Attempting to correct for what we deemed to be the most important influencing factors, age and different inclusions of long-term care costs, the Israeli healthcare system still seems to be 25% less expensive, compared to the Danish one, and with better health outcomes. This is not necessarily a function of the Israeli healthcare system but may to a great extent be explained by cultural factors, mainly a much lower Israeli alcohol consumption.
Subject(s)
Delivery of Health Care , Health Expenditures , Denmark , Humans , Israel , Organisation for Economic Co-Operation and DevelopmentABSTRACT
Five different semiautomatic manometers were tested, where oscillometry is the measuring principle. Three of the manometers (Omron R4, A&D UB 322 and Braun) were wrist manometers, where the occluding cuff is placed around the volar surface of the wrist. Two of the manometers (A&D UA 777 and Omron M4) measure on the upper arm. The investigation included 72 patients with systolic blood pressure (SBP) ranging between 110 and 200, and diastolic blood pressure (DBP) between 62 and 114 mmHg. Forty-five of the subjects were on antihypertensive medication when the manometer tests were carried out. Each of the manometers was tested with double measurements of blood pressure against 2 x 2 auscultatory measurements done before and after the semiautomatic readings. The auscultatory measurements are all performed by the same observer, who was blinded for the measurements with semiautomatic manometers. The mean difference between the oscillometric recordings compared to auscultatory measurements varied from +1.2 to -8.5 mmHg for SBP and from -0.5 to -8.3 mmHg for DBP. However, the interindividual differences varied considerable with standard deviation of the difference varying from 8 to 18 mmHg for SBP with the highest values for wrist manometers. Concerning DBP, the standard deviation of difference for all five manometers was between 6 and 8 mmHg, with the highest values for wrist manometers. None of the tested manometers fulfilled the criteria for grading A or B in the previously introduced grading by the British Hypertension Society. To conclude, the upper-arm manometers have a measuring accuracy for SBP a little higher than that of the wrist manometers, while there is no bigger difference in the measuring accuracy of DBP. The most important point is that the measuring accuracy in a single patient is unpredictable. If home readings are prepared, a test of the accuracy against auscultatory recordings should be done in every single patient. In the clinical wards, it is important to be aware of the measuring accuracy if oscillometric measurements are introduced replacing auscultatory measurements.
